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目的探讨新生儿母子血型不合溶血病血清学变化特征。方法选择我院2010年10月至2011年9月考虑母子血型不合溶血病所致新生儿高胆红素血症的患儿,回顾性分析患儿及母亲血型、新生儿溶血检测结果,并比较不同血型不合新生儿溶血病发生率、胆红素水平、Coomb’s试验、抗体弥散试验等结果。结果共收治母子血型不合的高胆红素血症患儿258例,入院日龄均≤72 h,其中O-A血型不合122例,O-B血型不合118例,Rh血型不合18例;发生溶血患儿分别为94例(77.0%)、85例(72.0%)、18例(100%);入院后最高胆红素分别为(352.0±120.2)、(383.9±116.3)、(455.9±145.4)μmol/L。Rh组胆红素水平和溶血发生率均高于O-A组和O-B组(P<0.05),O-A组和O-B组差异无统计学意义(P>0.05)。3组发生溶血患儿抗体弥散试验阳性率58.4%(115/197),Coomb’s试验阳性率19.3%(38/197)。O-A血型不合、O-B血型不合、Rh血型不合溶血病患儿Coomb’s试验阳性例数分别为18例(19.1%)、4例(4.7%),16例(88.9%),O-A血型不合、O-B血型不合溶血病患儿抗体弥散试验阳性例数分别为68例(72.3%)、47例(55.3%)。结论 Rh血型不合较ABO血型不合溶血患儿血清胆红素峰值、Coomb’s试验阳性率高,新生儿溶血病发生的严重程度与母亲血清Ig G亚型相关。
Objective To investigate the serological changes of newborn children with hemolytic incompatibility. Methods Select our hospital from October 2010 to September 2011 to consider the mother and child hemolytic disease caused by hemolytic disease in children with neonatal hyperbilirubinemia, retrospective analysis of children and mothers blood group, newborn hemolytic test results, and compared Different blood group neonates with hemolytic disease incidence, bilirubin levels, Coomb’s test, antibody dispersion test results. Results A total of 258 cases of children with hyperbilirubinemia were enrolled in this study. All patients were admitted to hospital for a mean of 72 days, including 122 cases of OA, 118 cases of OB and 18 cases of Rh. The highest bilirubin levels were (352.0 ± 120.2), (383.9 ± 116.3) and (455.9 ± 145.4) μmol / L after admission in 94 patients (77.0%), 85 patients (72.0%) and 18 patients . The level of bilirubin and hemolysis in Rh group were higher than those in O-A and O-B groups (P <0.05). There was no significant difference between O-A group and O-B group (P> 0.05). The positive rate of antibody diffusion test was 58.4% (115/197) in haemolytic children and 19.3% (38/197) in Coomb’s test. There were 18 cases (19.1%), 4 cases (4.7%), 16 cases (88.9%) with OA blood group incompatibility, OB blood group incompatibility and Co blood group hemolytic disease The positive number of antibody diffusion test in children with hemolytic disease were 68 (72.3%) and 47 (55.3%) respectively. CONCLUSIONS: Rh blood group incompatibility is higher than that of children with ABO incompatible hemolysis. The positive rate of Coomb’s test is high. The severity of neonatal hemolytic disease is related to maternal serum Ig G subtype.